# entry[].resource.item[].text
Elements for Cognitive Performance Scale (CPS)

# entry[].resource.item[].item[].text
1. Cognitive skills for daily decision making: Making decisions regarding tasks of daily life-e.g., when to get up or have meals, which clothes to wear or activities to do

# entry[].resource.item[].item[].answerOption[].valueCoding.display
0 Independent - decisions consistent, reasonable, and safe

# entry[].resource.item[].item[].answerOption[].valueCoding.display
1 Modified independence - some difficulty in new situations only

# entry[].resource.item[].item[].answerOption[].valueCoding.display
2 Minimally impaired - In specific recurring situations, decisions become poor or unsafe; cues / supervision necessary at those times

# entry[].resource.item[].item[].answerOption[].valueCoding.display
3 Moderately impaired - Decisions consistently poor or unsafe; cues / supervision required at all times

# entry[].resource.item[].item[].answerOption[].valueCoding.display
4 Severely impaired - Never or rarely make decisions

# entry[].resource.item[].item[].text
2. Short-term memory OK - Seems / appears to recall after 5 minutes

# entry[].resource.item[].item[].text
3. Making self understood (Expression): Expressing information content - both verbal and non-verbal

# entry[].resource.item[].item[].answerOption[].valueCoding.display
0 Understood-Expresses ideas without difficulty

# entry[].resource.item[].item[].answerOption[].valueCoding.display
1 Usually understood - Difficulty finding words or finishing thoughts BUT if given time, little or no prompting required

# entry[].resource.item[].item[].answerOption[].valueCoding.display
2 Often understood - Difficulty finding words or finishing thoughts AND prompting usually required

# entry[].resource.item[].item[].answerOption[].valueCoding.display
3 Sometimes understood - Ability is limited to making concrete requests

# entry[].resource.item[].item[].text
4. Eating - How RESIDENT eats and drinks (regardless of skill). Includes intake of nourishment by other means (e.g., tube feeding, total parenteral nutrition)

# entry[].resource.item[].item[].answerOption[].valueCoding.display
0. Independent - No physical assistance, setup, or supervision in any episode

# entry[].resource.item[].item[].answerOption[].valueCoding.display
1. Independent, setup help only - Article or device provided or placed within reach, no physical assistance or supervision in any episode

# entry[].resource.item[].item[].answerOption[].valueCoding.display
3. Limited assistance - Guided manoeuvring of limbs, physical guidance without taking weight

# entry[].resource.item[].item[].answerOption[].valueCoding.display
4. Extensive assistance - Weight-bearing support (including lifting limbs) by 1 helper where person still performs 50% or more of subtasks

# entry[].resource.item[].item[].answerOption[].valueCoding.display
5. Maximal assistance - Weight-bearing support (including lifting limbs) by 2+ helpers-OR-weight-bearing support for more than 50% of subtasks

# entry[].resource.item[].item[].answerOption[].valueCoding.display
6. Total dependence - Full performance by others during all episodes

# entry[].resource.item[].item[].answerOption[].valueCoding.display
8. Activity did not occur during entire period

# entry[].resource.item[].text
Elements for Cognitive Performance Scale (CPS)

# entry[].resource.item[].item[].text
1. Cognitive skills for daily decision making: Making decisions regarding tasks of daily life-e.g., when to get up or have meals, which clothes to wear or activities to do

# entry[].resource.item[].item[].answerOption[].valueCoding.display
0 Independent - decisions consistent, reasonable, and safe

# entry[].resource.item[].item[].answerOption[].valueCoding.display
1 Modified independence - some difficulty in new situations only

# entry[].resource.item[].item[].answerOption[].valueCoding.display
2 Minimally impaired - In specific recurring situations, decisions become poor or unsafe; cues / supervision necessary at those times

# entry[].resource.item[].item[].answerOption[].valueCoding.display
3 Moderately impaired - Decisions consistently poor or unsafe; cues / supervision required at all times

# entry[].resource.item[].item[].answerOption[].valueCoding.display
4 Severely impaired - Never or rarely make decisions

# entry[].resource.item[].item[].text
2. Short-term memory OK - Seems / appears to recall after 5 minutes

# entry[].resource.item[].item[].text
3. Making self understood (Expression): Expressing information content - both verbal and non-verbal

# entry[].resource.item[].item[].answerOption[].valueCoding.display
0 Understood-Expresses ideas without difficulty

# entry[].resource.item[].item[].answerOption[].valueCoding.display
1 Usually understood - Difficulty finding words or finishing thoughts BUT if given time, little or no prompting required

# entry[].resource.item[].item[].answerOption[].valueCoding.display
2 Often understood - Difficulty finding words or finishing thoughts AND prompting usually required

# entry[].resource.item[].item[].answerOption[].valueCoding.display
3 Sometimes understood - Ability is limited to making concrete requests

# entry[].resource.item[].item[].text
4. Eating - How RESIDENT eats and drinks (regardless of skill). Includes intake of nourishment by other means (e.g., tube feeding, total parenteral nutrition)

# entry[].resource.item[].item[].answerOption[].valueCoding.display
0. Independent - No physical assistance, setup, or supervision in any episode

# entry[].resource.item[].item[].answerOption[].valueCoding.display
1. Independent, setup help only - Article or device provided or placed within reach, no physical assistance or supervision in any episode

# entry[].resource.item[].item[].answerOption[].valueCoding.display
3. Limited assistance - Guided manoeuvring of limbs, physical guidance without taking weight

# entry[].resource.item[].item[].answerOption[].valueCoding.display
4. Extensive assistance - Weight-bearing support (including lifting limbs) by 1 helper where person still performs 50% or more of subtasks

# entry[].resource.item[].item[].answerOption[].valueCoding.display
5. Maximal assistance - Weight-bearing support (including lifting limbs) by 2+ helpers-OR-weight-bearing support for more than 50% of subtasks

# entry[].resource.item[].item[].answerOption[].valueCoding.display
6. Total dependence - Full performance by others during all episodes

# entry[].resource.item[].item[].answerOption[].valueCoding.display
8. Activity did not occur during entire period

# entry[].resource.item[].text
Elements for Cognitive Performance Scale (CPS)

# entry[].resource.item[].item[].text
1. Cognitive skills for daily decision making: Making decisions regarding tasks of daily life-e.g., when to get up or have meals, which clothes to wear or activities to do

# entry[].resource.item[].item[].answerOption[].valueCoding.display
0 Independent - decisions consistent, reasonable, and safe

# entry[].resource.item[].item[].answerOption[].valueCoding.display
1 Modified independence - some difficulty in new situations only

# entry[].resource.item[].item[].answerOption[].valueCoding.display
2 Minimally impaired - In specific recurring situations, decisions become poor or unsafe; cues / supervision necessary at those times

# entry[].resource.item[].item[].answerOption[].valueCoding.display
3 Moderately impaired - Decisions consistently poor or unsafe; cues / supervision required at all times

# entry[].resource.item[].item[].answerOption[].valueCoding.display
4 Severely impaired - Never or rarely make decisions

# entry[].resource.item[].item[].text
2. Short-term memory OK - Seems / appears to recall after 5 minutes

# entry[].resource.item[].item[].text
3. Making self understood (Expression): Expressing information content - both verbal and non-verbal

# entry[].resource.item[].item[].answerOption[].valueCoding.display
0 Understood-Expresses ideas without difficulty

# entry[].resource.item[].item[].answerOption[].valueCoding.display
1 Usually understood - Difficulty finding words or finishing thoughts BUT if given time, little or no prompting required

# entry[].resource.item[].item[].answerOption[].valueCoding.display
2 Often understood - Difficulty finding words or finishing thoughts AND prompting usually required

# entry[].resource.item[].item[].answerOption[].valueCoding.display
3 Sometimes understood - Ability is limited to making concrete requests

# entry[].resource.item[].item[].text
4. Eating - How RESIDENT eats and drinks (regardless of skill). Includes intake of nourishment by other means (e.g., tube feeding, total parenteral nutrition)

# entry[].resource.item[].item[].answerOption[].valueCoding.display
0. Independent - No physical assistance, setup, or supervision in any episode

# entry[].resource.item[].item[].answerOption[].valueCoding.display
1. Independent, setup help only - Article or device provided or placed within reach, no physical assistance or supervision in any episode

# entry[].resource.item[].item[].answerOption[].valueCoding.display
3. Limited assistance - Guided manoeuvring of limbs, physical guidance without taking weight

# entry[].resource.item[].item[].answerOption[].valueCoding.display
4. Extensive assistance - Weight-bearing support (including lifting limbs) by 1 helper where person still performs 50% or more of subtasks

# entry[].resource.item[].item[].answerOption[].valueCoding.display
5. Maximal assistance - Weight-bearing support (including lifting limbs) by 2+ helpers-OR-weight-bearing support for more than 50% of subtasks

# entry[].resource.item[].item[].answerOption[].valueCoding.display
6. Total dependence - Full performance by others during all episodes

# entry[].resource.item[].item[].answerOption[].valueCoding.display
8. Activity did not occur during entire period

# entry[].resource.text.div
Answer Expression Demonstration - Selecting Language in various ways

Status: Active
Publisher: DEMO: HL7 International - SDC

# entry[].resource.extension[].extension[].valueString
The patient that is to be used to pre-populate the form, and provide context for variable based expressions

# entry[].resource.title
Answer Expression Demonstration - Selecting Language in various ways

# entry[].resource.item[].item[].text
Each of the questions in this section leverage different techniques for selecting possible values for the options

# entry[].resource.item[].item[]._text.extension[].valueMarkdown
**Each of the questions in this section leverage different techniques for selecting possible values for the options**

# entry[].resource.item[].item[].text
Locally defined codings - no terminology server

# entry[].resource.item[].item[]._text.extension[].valueMarkdown
_Locally defined codings - no terminology server_

# entry[].resource.item[].item[].text
contained ValueSet with included expansion - no terminology server

# entry[].resource.item[].item[]._text.extension[].valueMarkdown
_contained ValueSet with included expansion - no terminology server_

# entry[].resource.item[].item[].text
Canonical Vaueset Reference (no version) - not terminology server specific

# entry[].resource.item[].item[]._text.extension[].valueMarkdown
_Canonical Vaueset Reference (no version) - not terminology server specific_

# entry[].resource.item[].item[].text
language (valueset canonical - no version)

# entry[].resource.item[].item[].text
Canonical Vaueset Reference (version specific) - not terminology server specific

# entry[].resource.item[].item[]._text.extension[].valueMarkdown
_Canonical Vaueset Reference (version specific) - not terminology server specific_

# entry[].resource.item[].item[].text
language (valueset canonical - with version - 3.0.2)

# entry[].resource.item[].item[].text
Canonical Valueset Reference (no version) - preferred terminology server

# entry[].resource.item[].item[]._text.extension[].valueMarkdown
_Canonical Valueset Reference (no version) - preferred terminology server_

# entry[].resource.item[].item[].text
language (valueset canonical - preferred server - ontoserver)

# entry[].resource.item[].item[].text
language (valueset canonical - preferred server - ontoserver)

# entry[].resource.item[].item[].text
Options from a coding expanded using a fhir query, and a fhirpath expression. Useful when the expression is effected by other values on the form

# entry[].resource.item[].item[]._text.extension[].valueMarkdown
_Options from a coding expanded using a fhir query, and a fhirpath expression. Useful when the expression is effected by other values on the form_

# entry[].resource.item[].item[].extension[].valueExpression.description
Variable to hold the results of the expansion

# entry[].resource.item[].item[].extension[].valueExpression.description
select the coded values from the expansion results in the above expression

# entry[].resource.item[].item[].text
Options read from the launch context (Context Patient's known languages)

# entry[].resource.item[].item[]._text.extension[].valueMarkdown
_Languages extracted from the patient in the launch context_

# entry[].resource.item[].item[].text
Explicit Vaueset Reference - URL direct to the valueset on a specific terminology server

# entry[].resource.item[].item[]._text.extension[].valueMarkdown
_Explicit Vaueset Reference (STU3/DSTU2 old style reference - not conformant with R4, but testing backward compatibility error handling)_

# entry[].resource.text.div
Bit of everything

Status: Active
Publisher: DEMO: Telstra Health

# entry[].resource.text.div
Argonaut Questionnaire Sampler

Publisher: Argonaut Project

# entry[].resource.copyright
You can copy, modify, distribute and perform the work, even for commercial purposes, all without asking permission.

# entry[].resource.item[].item[].text
The Argonaut Questionnaire Sampler is designed to show all the question types that can be used in the Argonaut Questionnaire Project:

1 boolean
2 decimal
3 integer
4 dateDate
5 dateTime
6 timeTime
7 string
8 textText
9 urlUrl
10 choice
11 open-choice
12 quantity

# entry[].resource.item[].item[].text
Check the box if the following statement is true.  The average air speed velocity of a laden European swallow is greater than a laden African swallow.

# entry[].resource.item[].item[].text
What is the average air speed velocity of a laden swallow in m/sec?

# entry[].resource.item[].item[].text
What is the average air speed velocity of a laden swallow in m/sec?

# entry[].resource.item[].item[].text
If a laden swallow left Camelot on 7/5/2018 what day would it reach the Castle Anthrax?

# entry[].resource.item[].item[].text
If a laden swallow left Camelot on 7/5/2018 and noon when would it reach Castle Anthrax?

# entry[].resource.item[].item[].text
If a laden swallow left Camelot at noon what time would it reach Castle Anthrax?

# entry[].resource.item[].item[].text
Describe how to estimate the average air speed velocity of a laden swallow in 20 words or less.

# entry[].resource.item[].item[].text
Describe in detal how to estimate the average air speed velocity of a laden swallow. Please cite your sources and give examples.

# entry[].resource.item[].item[].text
Provide a link to a video clip where the average air speed velocity of a laden swallow question is discussed.

# entry[].resource.item[].item[].text
What is the average air speed velocity of a laden swallow in m/sec?

# entry[].resource.item[].item[].text
What is the average air speed velocity of a laden swallow in m/sec?

# entry[].resource.item[].item[].text
What is the average air speed velocity of a laden swallow - please provide the units?

# entry[].resource.text.div
Fitness Study

Status: Active

# entry[].resource.text.div
interRAI Long-Term Care Facilities Assessment Form

# entry[].resource.title
interRAI Long-Term Care Facilities Assessment Form

# entry[].resource.item[].item[].answerOption[].valueCoding.display
Significant change in status reassessment

# entry[].resource.item[].item[].answerOption[].valueCoding.display
Discharge assessment, covers last 3 days of service

# entry[].resource.item[].item[].code[].display
TIME SINCE LAST HOSPITAL STAY - Code for most recent instance in LAST 90 DAYS

# entry[].resource.item[].item[].text
10. TIME SINCE LAST HOSPITAL STAY - Code for most recent instance in LAST 90 DAYS

# entry[].resource.item[].item[].item[].text
Code for most recent instance in LAST 90 DAYS

# entry[].resource.item[].item[].code[].display
Level of control person had over decision to move into LTCF

# entry[].resource.item[].item[].text
1. Level of control person had over decision to move into LTCF

# entry[].resource.item[].item[].item[].text
b. Indigenous status - Is the client of Aboriginal or Torres Strait Islander origin?

# entry[].resource.item[].item[].code[].display
PRIMARY LANGUAGE - Main language spoken at home

# entry[].resource.item[].item[].text
4. PRIMARY LANGUAGE - Main language spoken at home

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
Private residence - owned/purchasing - Client owns/is purchasing - Family member or related person owns/is purchasing

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
Private residence - public rental or community housing; indigenous community / settlement

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
Independent living within retirement village

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
Boarding house / rooming house / private hostel

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
Short-term crisis, emergency, or transactional accommodation

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
Mental health residence—e.g., psychiatric group home

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
Group home for persons with physical disability

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
Setting for persons with intellectual disability

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
Residential aged care service - low-level care

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
Residential aged care service - high-level care

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
Private residence - owned/purchasing - Client owns/is purchasing - Family member or related person owns/is purchasing

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
Private residence - public rental or community housing; indigenous community / settlement

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
Independent living within retirement village

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
Boarding house / rooming house / private hostel

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
Short-term crisis, emergency, or transactional accommodation

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
Mental health residence—e.g., psychiatric group home

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
Group home for persons with physical disability

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
Setting for persons with intellectual disability

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
Residential aged care service - low-level care

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
Residential aged care service - high-level care

# entry[].resource.item[].item[].code[].display
Post code of usual living arrangement prior to admission

# entry[].resource.item[].item[].text
6. Post code of usual living arrangement prior to admission

# entry[].resource.item[].item[].text
7. Living arrangement prior to admission

# entry[].resource.item[].item[].text
8. Residential History Over Last 5 Years

# entry[].resource.item[].item[].item[].text
Code for all settings person lived in during 5 YEARS prior to date stay began (Item B2)

# entry[].resource.item[].item[].item[].text
a. Long-term care facility - e.g., nursing home, chronic sick unit

# entry[].resource.item[].item[].item[].code[].display
b. Board and care home, assisted living, group home

# entry[].resource.item[].item[].item[].text
b. Board and care home, assisted living, group home

# entry[].resource.item[].item[].item[].text
c. Mental health residence-e.g., psychiatric group home

# entry[].resource.item[].item[].item[].code[].display
e. Setting for persons with intellectual disability

# entry[].resource.item[].item[].item[].text
e. Setting for persons with intellectual disability

# entry[].resource.item[].item[].text
9. MENTAL HEALTH - Record indicates history of mental illness or intellectual disability

# entry[].resource.item[].item[].item[].text
Record indicates history of mental illness or intellectual disability

# entry[].resource.item[].item[].text
Making decisions regarding tasks of daily life-e.g., when to get up or have meals, which clothes to wear or activities to do

# entry[].resource.item[].item[].code[].display
COGNITIVE SKILLS FOR DAILY DECISION MAKING - Making decisions regarding tasks of daily life-e.g., when to get up or have meals, which clothes to wear or activities to do

# entry[].resource.item[].item[].text
1. COGNITIVE SKILLS FOR DAILY DECISION MAKING - Making decisions regarding tasks of daily life-e.g., when to get up or have meals, which clothes to wear or activities to do

# entry[].resource.item[].item[].answerOption[].valueCoding.display
Modified independence-some difficulty in new situations only

# entry[].resource.item[].item[].answerOption[].valueCoding.display
Minimally impaired  - In specific recurring situations, decisions become poor or unsafe; cues / supervision necessary at those times

# entry[].resource.item[].item[].answerOption[].valueCoding.display
Moderately impaired - Decisions consistently poor or unsafe; cues / supervision required at all times

# entry[].resource.item[].item[].answerOption[].valueCoding.display
Severely impaired - Never or rarely make decisions

# entry[].resource.item[].item[].item[].text
Code for recall of what was learned or known

# entry[].resource.item[].item[].item[].text
a. Short-term memory OK-Seems / appears to recall after 5 minutes

# entry[].resource.item[].item[].item[].text
b. Procedural memory OK-Can perform all or almost all steps in a multitask sequence without cues

# entry[].resource.item[].item[].item[].text
c. Situational memory OK- Both: recognizes caregiver's names / faces frequently encountered AND knows location of places regularly visited  (bedroom, dining room, activity, therapy room)

# entry[].resource.item[].item[].item[].text
d. Long-term memory OK-Seems / appears to recall distant past

# entry[].resource.item[].item[].text
3. Periodic disordered thinking or awareness

# entry[].resource.item[].item[].item[].text
[Note: Accurate assessment requires conversations with staff, family, or others who have direct knowledge of the person's behaviour over this time]

# entry[].resource.item[].item[].item[].text
a. Easily distracted-e.g., episodes of difficulty paying attention; gets sidetracked

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
Behaviour present, consistent with usual functioning

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
Behaviour present, appears different from usual functioning (e.g., new onset or worsening; different from a few weeks ago)

# entry[].resource.item[].item[].item[].text
b. Episodes of disorganized speech-e.g., speech is nonsensical, irrelevant, or rambling from subject to subject; loses train of thought

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
Behaviour present, consistent with usual functioning

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
Behaviour present, appears different from usual functioning (e.g., new onset or worsening; different from a few weeks ago)

# entry[].resource.item[].item[].item[].code[].display
c. Mental Function varies over the course of the day

# entry[].resource.item[].item[].item[].text
c. Mental Function varies over the course of the day-e.g., sometimes better, sometimes worse

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
Behaviour present, consistent with usual functioning

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
Behaviour present, appears different from usual functioning (e.g., new onset or worsening; different from a few weeks ago)

# entry[].resource.item[].item[].code[].display
Acute change in mental status from person's usual functioning

# entry[].resource.item[].item[].text
4. Acute change in mental status from person's usual functioning - e.g., restlessness, lethargy, difficult to arouse, altered environmental perception

# entry[].resource.item[].item[].code[].display
Change in decision making as compared to 90 days ago

# entry[].resource.item[].item[].text
5. Change in decision making as compared to 90 days ago (or since last assessment)

# entry[].resource.item[].item[].text
1. MAKING SELF UNDERSTOOD (EXPRESSION): Expressing information content - both verbal and non-verbal

# entry[].resource.item[].item[].answerOption[].valueCoding.display
0. Understood—Expresses ideas without difficulty

# entry[].resource.item[].item[].answerOption[].valueCoding.display
1. Usually understood—Difficulty finding words or finishing thoughts BUT if given time, little or no prompting required

# entry[].resource.item[].item[].answerOption[].valueCoding.display
2. Often understood—Difficulty finding words or finishing thoughts AND prompting usually required

# entry[].resource.item[].item[].answerOption[].valueCoding.display
3. Sometimes understood—Ability is limited to making concrete requests

# entry[].resource.item[].item[].item[].text
Expressing information content - both verbal and non-verbal

# entry[].resource.item[].item[].text
2. ABILITY TO UNDERSTAND OTHERS (COMPREHENSION) - Understanding verbal information content (however able; with hearing appliance normally used)

# entry[].resource.item[].item[].answerOption[].valueCoding.display
1. Usually understands—Misses some part / intent of message BUT comprehends most conversation

# entry[].resource.item[].item[].answerOption[].valueCoding.display
2. Often understands—Misses some part / intent of message BUT with repetition or explanation can often comprehend conversation

# entry[].resource.item[].item[].answerOption[].valueCoding.display
3. Sometimes understands—Responds adequately to simple, direct communication only

# entry[].resource.item[].item[].item[].text
Understanding verbal information content (however able; with hearing appliance normally used)

# entry[].resource.item[].item[].item[].code[].display
a. Ability to hear (with hearing appliance normally used)

# entry[].resource.item[].item[].item[].text
a. Ability to hear (with hearing appliance normally used)

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
0. Adequate—No difficulty in normal conversation, social interaction, listening to TV

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Minimal difficulty—Difficulty in some environments (e.g., when person speaks softly or is more than 6 feet [2 meters] away)

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
2. Moderate difficulty—Problem hearing normal conversation, requires quiet setting to hear well

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Severe difficulty—Difficulty in all situations (e.g., speaker has to talk loudly or speak very slowly; or person reports that all speech is mumbled)

# entry[].resource.item[].item[].item[].text
a. Ability to see in adequate light (with glasses or with other appliance normally used)

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
0. Adequate—Sees fine detail, including regular print in newspapers / books

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Minimal difficulty—Sees large print but not regular print in newspapers / books

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
2. Moderate difficulty—Limited vision; not able to see newspaper headlines but can identify objects

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Severe difficulty—Object identification in question, but eyes appear to follow objects; sees only light, colours, shapes

# entry[].resource.item[].item[].code[].display
Indicators of possible depressed, anxious, or sad mood

# entry[].resource.item[].item[].text
1. Indicators of possible depressed, anxious, or sad mood

# entry[].resource.item[].item[].item[].text
Code for indicators observed in last 3 days, irrespective of the assumed cause [Note: Whenever possible, ask person.]

# entry[].resource.item[].item[].item[].text
a. Made negative statements - e.g., "Nothing matters"; "Would rather be dead"; "What's the use"; "Regret having lived so long"; "Let me die"

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Present but not exhibited in last 3 days

# entry[].resource.item[].item[].item[].text
b. Persistent anger with self or others - e.g., easily annoyed, anger at care received

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Present but not exhibited in last 3 days

# entry[].resource.item[].item[].item[].code[].display
c. Expressions, including non-verbal, of what appears to be unrealistic fears

# entry[].resource.item[].item[].item[].text
c. Expressions, including non-verbal, of what appears to be unrealistic fears - e.g., fear of being abandoned, being left alone, being with others, intense fear of specific objects or situations

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Present but not exhibited in last 3 days

# entry[].resource.item[].item[].item[].text
d. Repetitive health complaints - e.g., persistently seeks medical attention, incessant concern with body functions

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Present but not exhibited in last 3 days

# entry[].resource.item[].item[].item[].text
e. Repetitive anxious complaints/concerns (non-health-related) - e.g., persistently seeks attention/reassurance regarding schedules, meals, laundry, clothing, relationships

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Present but not exhibited in last 3 days

# entry[].resource.item[].item[].item[].code[].display
f. Sad, pained, or worried facial expressions

# entry[].resource.item[].item[].item[].text
f. Sad, pained, or worried facial expressions - e.g., furrowed brow, constant frowning

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Present but not exhibited in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Present but not exhibited in last 3 days

# entry[].resource.item[].item[].item[].code[].display
h. Recurrent statements that something terrible is about to happen

# entry[].resource.item[].item[].item[].text
h. Recurrent statements that something terrible is about to happen - e.g., believes he or she is about to die, have a heart attack

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Present but not exhibited in last 3 days

# entry[].resource.item[].item[].item[].code[].display
i. Withdrawal from activities of interest

# entry[].resource.item[].item[].item[].text
i. Withdrawal from activities of interest - e.g., long-standing activities, being with family/friends

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Present but not exhibited in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Present but not exhibited in last 3 days

# entry[].resource.item[].item[].item[].code[].display
k. Expressions, including non-verbal, of a lack of pleasure in life (anhedonia)

# entry[].resource.item[].item[].item[].text
k. Expressions, including non-verbal, of a lack of pleasure in life (anhedonia) - e.g., "I don’t enjoy anything anymore"

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Present but not exhibited in last 3 days

# entry[].resource.item[].item[].code[].display
Self-reported mood - "In the last 3 days, how often have you felt…"

# entry[].resource.item[].item[].text
2. Self-reported mood - "In the last 3 days, how often have you felt…"

# entry[].resource.item[].item[].item[].text
Ask: "In the last 3 days, how often have you felt…"

# entry[].resource.item[].item[].item[].code[].display
a. Little interest or pleasure in things you normally enjoy?

# entry[].resource.item[].item[].item[].text
a. Little interest or pleasure in things you normally enjoy?

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Not in last 3 days but often feels that way

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Not in last 3 days but often feels that way

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Not in last 3 days but often feels that way

# entry[].resource.item[].item[].item[].text
Code for indicators observed, irrespective of the assumed cause

# entry[].resource.item[].item[].item[].text
a. Wandering - Moved with no rational purpose, seemingly oblivious to needs or safety

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Present but not exhibited in last 3 days

# entry[].resource.item[].item[].item[].text
b. Verbal abuse - e.g., others were threatened, screamed at, cursed at

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Present but not exhibited in last 3 days

# entry[].resource.item[].item[].item[].text
c. Physical abuse - e.g., others were hit, shoved, scratched, sexually abused

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Present but not exhibited in last 3 days

# entry[].resource.item[].item[].item[].code[].display
d. Socially inappropriate or disruptive behaviour

# entry[].resource.item[].item[].item[].text
d. Socially inappropriate or disruptive behaviour - e.g., made disruptive sounds or noise, screamed out, smeared or threw food or faeces, hoarded, rummaged through other's belongings

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Present but not exhibited in last 3 days

# entry[].resource.item[].item[].item[].code[].display
e. Inappropriate public sexual behaviour or public disrobing

# entry[].resource.item[].item[].item[].text
e. Inappropriate public sexual behaviour or public disrobing

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Present but not exhibited in last 3 days

# entry[].resource.item[].item[].item[].text
f. Resists care - e.g., taking medications/injections, ADL assistance, eating

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Present but not exhibited in last 3 days

# entry[].resource.item[].item[].text
[Note: Ask person, direct care staff, and family, if available.]

# entry[].resource.item[].item[].item[].code[].display
a. Participation in social activities of long-standing interest

# entry[].resource.item[].item[].item[].text
a. Participation in social activities of long-standing interest

# entry[].resource.item[].item[].item[].code[].display
b. Visit with a long-standing social relation or family member

# entry[].resource.item[].item[].item[].text
b. Visit with a long-standing social relation or family member

# entry[].resource.item[].item[].item[].code[].display
c. Other interaction with long-standing social relation or family member

# entry[].resource.item[].item[].item[].text
c. Other interaction with long-standing social relation or family member - e.g., telephone, e-mail

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Present but not exhibited in last 3 days

# entry[].resource.item[].item[].item[].code[].display
b. At ease doing planned or structured activities

# entry[].resource.item[].item[].item[].text
b. At ease doing planned or structured activities

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Present but not exhibited in last 3 days

# entry[].resource.item[].item[].item[].code[].display
c. Accepts invitations into most group activities

# entry[].resource.item[].item[].item[].text
c. Accepts invitations into most group activities

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Present but not exhibited in last 3 days

# entry[].resource.item[].item[].item[].code[].display
d. Pursues involvement in life of facility

# entry[].resource.item[].item[].item[].text
d. Pursues involvement in life of facility - e.g., makes or keeps friends; involved in group activities; responds positively to new activities; assists at religious services

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Present but not exhibited in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Present but not exhibited in last 3 days

# entry[].resource.item[].item[].item[].code[].display
f. Reacts positively to interactions initiated by others

# entry[].resource.item[].item[].item[].text
f. Reacts positively to interactions initiated by others

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Present but not exhibited in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Present but not exhibited in last 3 days

# entry[].resource.item[].item[].item[].code[].display
a. Conflict with or repeated criticism of other care recipients

# entry[].resource.item[].item[].item[].text
a. Conflict with or repeated criticism of other care recipients

# entry[].resource.item[].item[].item[].code[].display
b. Conflict with or repeated criticism of staff

# entry[].resource.item[].item[].item[].text
b. Conflict with or repeated criticism of staff

# entry[].resource.item[].item[].item[].code[].display
c. Staff report persistent frustration in dealing with person

# entry[].resource.item[].item[].item[].text
c. Staff report persistent frustration in dealing with person

# entry[].resource.item[].item[].item[].code[].display
d. Family or close friends report feeling overwhelmed by person’s condition

# entry[].resource.item[].item[].item[].text
d. Family or close friends report feeling overwhelmed by person’s condition

# entry[].resource.item[].item[].item[].code[].display
e. Says or indicates that he/she feels lonely

# entry[].resource.item[].item[].item[].text
e. Says or indicates that he/she feels lonely

# entry[].resource.item[].item[].code[].display
MAJOR LIFE STRESSORS IN LAST 90 DAYS - e.g., episode of severe personal illness; death or severe illness of close famiy member/friend; loss of home; major loss of income/assets; victim of a crime such as a robbery or assualt; loss of driving licence/car

# entry[].resource.item[].item[].text
4. MAJOR LIFE STRESSORS IN LAST 90 DAYS - e.g., episode of severe personal illness; death or severe illness of close famiy member/friend; loss of home; major loss of income/assets; victim of a crime such as a robbery or assualt; loss of driving licence/car

# entry[].resource.item[].item[].item[].code[].display
c. Strong and supportive relationship with family

# entry[].resource.item[].item[].item[].text
c. Strong and supportive relationship with family

# entry[].resource.item[].item[].text
"Consider all episodes over 3-day period.  If all episodes are performed at the same level, score ADL at that level. If any episodes at level 6, and others less dependent, score ADL as a 5. Otherwise, focus on the three most dependent episodes [or all episodes if performed fewer than 3 times]. If most dependent episode is 1, score ADL as 1. If not, score ADL as least dependent of those episodes in range 2-5."

# entry[].resource.item[].item[].item[].text
a. Bathing - How takes a full-body bath/shower. Includes how transfers in and out of tub or shower AND how each part of the body is bathed: arms, upper and lower legs, chest, abdomen, perineal area-EXCLUDE WASHING OF BACK AND HAIR

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
0. Independent—No physical assistance, setup, or supervision in any episode

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Independent, setup help only—Article or device provided or placed within reach, no physical assistance or supervision in any episode

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Limited assistance—Guided manoeuvring of limbs, physical guidance without taking weight

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
4. Extensive assistance—Weight-bearing support (including lifting limbs) by 1 helper where person still performs 50% or more of subtasks

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
5. Maximal assistance—Weight-bearing support (including lifting limbs) by 2+ helpers-OR-weight-bearing support for more than 50% of subtasks

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
6. Total dependence—Full performance by others during all episodes

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
8. Activity did not occur during entire period

# entry[].resource.item[].item[].item[].text
b. Personal hygiene - How manages personal hygiene, including combing hair, brushing teeth, shaving, applying make-up, washing ad drying face and hands - EXCLUDES BATHS AND SHOWERS

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
0. Independent—No physical assistance, setup, or supervision in any episode

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Independent, setup help only—Article or device provided or placed within reach, no physical assistance or supervision in any episode

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Limited assistance—Guided manoeuvring of limbs, physical guidance without taking weight

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
4. Extensive assistance—Weight-bearing support (including lifting limbs) by 1 helper where person still performs 50% or more of subtasks

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
5. Maximal assistance—Weight-bearing support (including lifting limbs) by 2+ helpers-OR-weight-bearing support for more than 50% of subtasks

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
6. Total dependence—Full performance by others during all episodes

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
8. Activity did not occur during entire period

# entry[].resource.item[].item[].item[].text
c. Dressing upper body - How dresses and undresses  (street clothes, underwear) from above the waist, including prostheses, orthotics, fasteners, pullovers, etc.

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
0. Independent—No physical assistance, setup, or supervision in any episode

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Independent, setup help only—Article or device provided or placed within reach, no physical assistance or supervision in any episode

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Limited assistance—Guided manoeuvring of limbs, physical guidance without taking weight

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
4. Extensive assistance—Weight-bearing support (including lifting limbs) by 1 helper where person still performs 50% or more of subtasks

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
5. Maximal assistance—Weight-bearing support (including lifting limbs) by 2+ helpers-OR-weight-bearing support for more than 50% of subtasks

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
6. Total dependence—Full performance by others during all episodes

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
8. Activity did not occur during entire period

# entry[].resource.item[].item[].item[].text
d. Dressing lower body - How dresses and undresses (street clothes and underwear) from the waist down, including protheses, orthotics, belts, pants, skirts, shoes, fasteners, etc.

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
0. Independent—No physical assistance, setup, or supervision in any episode

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Independent, setup help only—Article or device provided or placed within reach, no physical assistance or supervision in any episode

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Limited assistance—Guided manoeuvring of limbs, physical guidance without taking weight

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
4. Extensive assistance—Weight-bearing support (including lifting limbs) by 1 helper where person still performs 50% or more of subtasks

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
5. Maximal assistance—Weight-bearing support (including lifting limbs) by 2+ helpers-OR-weight-bearing support for more than 50% of subtasks

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
6. Total dependence—Full performance by others during all episodes

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
8. Activity did not occur during entire period

# entry[].resource.item[].item[].item[].text
e. Walking - How walks between locations on same floor indoors

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
0. Independent—No physical assistance, setup, or supervision in any episode

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Independent, setup help only—Article or device provided or placed within reach, no physical assistance or supervision in any episode

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Limited assistance—Guided manoeuvring of limbs, physical guidance without taking weight

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
4. Extensive assistance—Weight-bearing support (including lifting limbs) by 1 helper where person still performs 50% or more of subtasks

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
5. Maximal assistance—Weight-bearing support (including lifting limbs) by 2+ helpers-OR-weight-bearing support for more than 50% of subtasks

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
6. Total dependence—Full performance by others during all episodes

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
8. Activity did not occur during entire period

# entry[].resource.item[].item[].item[].text
f. Locomotion - How moves between locations on same floor (walking or wheeling). If in wheelchair, self-sufficiency once in chair

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
0. Independent—No physical assistance, setup, or supervision in any episode

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Independent, setup help only—Article or device provided or placed within reach, no physical assistance or supervision in any episode

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Limited assistance—Guided manoeuvring of limbs, physical guidance without taking weight

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
4. Extensive assistance—Weight-bearing support (including lifting limbs) by 1 helper where person still performs 50% or more of subtasks

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
5. Maximal assistance—Weight-bearing support (including lifting limbs) by 2+ helpers-OR-weight-bearing support for more than 50% of subtasks

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
6. Total dependence—Full performance by others during all episodes

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
8. Activity did not occur during entire period

# entry[].resource.item[].item[].item[].text
g. Transfer toilet - How moves on and off toilet or commode

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
0. Independent—No physical assistance, setup, or supervision in any episode

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Independent, setup help only—Article or device provided or placed within reach, no physical assistance or supervision in any episode

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Limited assistance—Guided manoeuvring of limbs, physical guidance without taking weight

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
4. Extensive assistance—Weight-bearing support (including lifting limbs) by 1 helper where person still performs 50% or more of subtasks

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
5. Maximal assistance—Weight-bearing support (including lifting limbs) by 2+ helpers-OR-weight-bearing support for more than 50% of subtasks

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
6. Total dependence—Full performance by others during all episodes

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
8. Activity did not occur during entire period

# entry[].resource.item[].item[].item[].text
h. Toilet use - How uses the toilet room (or commode, bedpan, urinal), cleanses self after toilet use or incontinent episode(s), changes pad, manages ostomy or catheter, adjusts clothes - EXCLUDE TRANSFER ON AND OFF TOILET

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
0. Independent—No physical assistance, setup, or supervision in any episode

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Independent, setup help only—Article or device provided or placed within reach, no physical assistance or supervision in any episode

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Limited assistance—Guided manoeuvring of limbs, physical guidance without taking weight

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
4. Extensive assistance—Weight-bearing support (including lifting limbs) by 1 helper where person still performs 50% or more of subtasks

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
5. Maximal assistance—Weight-bearing support (including lifting limbs) by 2+ helpers-OR-weight-bearing support for more than 50% of subtasks

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
6. Total dependence—Full performance by others during all episodes

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
8. Activity did not occur during entire period

# entry[].resource.item[].item[].item[].text
i. Bed mobility - How moves to and from lying position, turns from side to side, and positions body while in bed

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
0. Independent—No physical assistance, setup, or supervision in any episode

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Independent, setup help only—Article or device provided or placed within reach, no physical assistance or supervision in any episode

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Limited assistance—Guided manoeuvring of limbs, physical guidance without taking weight

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
4. Extensive assistance—Weight-bearing support (including lifting limbs) by 1 helper where person still performs 50% or more of subtasks

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
5. Maximal assistance—Weight-bearing support (including lifting limbs) by 2+ helpers-OR-weight-bearing support for more than 50% of subtasks

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
6. Total dependence—Full performance by others during all episodes

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
8. Activity did not occur during entire period

# entry[].resource.item[].item[].item[].text
j. Eating - How eats and drinks (regardless of skill). Includes intake of nourishment by other means (e.g., tube feeding, total parenteral nutrition)

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
0. Independent—No physical assistance, setup, or supervision in any episode

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Independent, setup help only—Article or device provided or placed within reach, no physical assistance or supervision in any episode

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Limited assistance—Guided manoeuvring of limbs, physical guidance without taking weight

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
4. Extensive assistance—Weight-bearing support (including lifting limbs) by 1 helper where person still performs 50% or more of subtasks

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
5. Maximal assistance—Weight-bearing support (including lifting limbs) by 2+ helpers-OR-weight-bearing support for more than 50% of subtasks

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
6. Total dependence—Full performance by others during all episodes

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
8. Activity did not occur during entire period

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Walking, uses assistive device—e.g., cane, walker, crutch, pushing wheelchair

# entry[].resource.item[].item[].item[].code[].display
b. Timed 4-metre walk - Lay out a straight, unobstructed course. Have person stand in still position, feet just touching start line. Then say: "When I tell, begin to walk at a normal pace (with cane/walker if used)". This is not a test of how fast you can walk. Stop when I tell you to stop. Is this clear?" Assessor may demonstrate test. Then say: "Begin to walk now." Start stopwatch (or can count seconds) when first foot falls. End count when foot falls beyond 4-metre mark. Then say: "You may stop now.

# entry[].resource.item[].item[].item[].text
b. Timed 4-metre walk - Lay out a straight, unobstructed course. Have person stand in still position, feet just touching start line. Then say: "When I tell, begin to walk at a normal pace (with cane/walker if used)". This is not a test of how fast you can walk. Stop when I tell you to stop. Is this clear?" Assessor may demonstrate test. Then say: "Begin to walk now." Start stopwatch (or can count seconds) when first foot falls. End count when foot falls beyond 4-metre mark. Then say: "You may stop now.

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
99. Not tested - e.g. does not walk on own

# entry[].resource.item[].item[].item[].item[].text
Lay out a straight, unobstructed course. Have person stand in still position, feet just touching start line. Then say: "When I tell, begin to walk at a normal pace (with cane/walker if used)". This is not a test of how fast you can walk. Stop when I tell you to stop. Is this clear?" Assessor may demonstrate test. Then say: "Begin to walk now." Start stopwatch (or can count seconds) when first foot falls. End count when foot falls beyond 4-metre mark. Then say: "You may stop now."

# entry[].resource.item[].item[].item[].text
c. Distance walked - Farthest distance walked at one time without sitting down in the LAST 3 DAYS (with support as needed)

# entry[].resource.item[].item[].item[].text
d. Distance wheeled self - Farthest distance wheeled self at one time in the LAST 3 DAYS (includes independent use of motorised wheelchair)

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
2. Wheeled self less than 15 feet (under 5 metres)

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Wheeled self 15–149 feet (5–49 metres)

# entry[].resource.item[].item[].item[].code[].display
a. Total hours of exercise or physical activity in Last 3 days

# entry[].resource.item[].item[].item[].text
a. Total hours of exercise or physical activity in Last 3 days

# entry[].resource.item[].item[].item[].code[].display
b. Number of days went out of house or buildiing of residence in last 3 days

# entry[].resource.item[].item[].item[].text
b. In the LAST 3 DAYS, number of days went out of house or building in which he/she resides (no matter how short the period)

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Did not go out in last 3 days, but usually goes out over a 3-day period

# entry[].resource.item[].item[].text
4. Physical function improvement potential

# entry[].resource.item[].item[].item[].code[].display
a. Person believes he/she is capable of improved performance in physical function

# entry[].resource.item[].item[].item[].text
a. Person believes he/she is capable of improved performance in physical function

# entry[].resource.item[].item[].item[].code[].display
b. Care professional believes person is capable of improved performance in physical function

# entry[].resource.item[].item[].item[].text
b. Care professional believes person is capable of improved performance in physical function

# entry[].resource.item[].item[].code[].display
Change in ADL status as compared to 90 days ago (or since last assessment if less than 90 days ago)

# entry[].resource.item[].item[].text
5. Change in ADL status as compared to 90 days ago (or since last assessment if less than 90 days ago)

# entry[].resource.item[].item[].answerOption[].valueCoding.display
0. Continent - Complete control; DOES NOT USE any type of catheter or other urinary collection device

# entry[].resource.item[].item[].answerOption[].valueCoding.display
1. Control with any catheter or ostomy over last 3 days

# entry[].resource.item[].item[].answerOption[].valueCoding.display
2. Infrequently incontinent - Not incontinent over last 3 days, but does have incontinent episodes

# entry[].resource.item[].item[].answerOption[].valueCoding.display
3. Occasionally incontinent—Less than daily

# entry[].resource.item[].item[].answerOption[].valueCoding.display
4. Frequently incontinent—Daily, but some control present

# entry[].resource.item[].item[].answerOption[].valueCoding.display
8. Did not occur—No urine output from bladder in last 3 days

# entry[].resource.item[].item[].code[].display
Urinary collection device (excludes pads/briefs)

# entry[].resource.item[].item[].text
2. Urinary collection device (excludes pads/briefs)

# entry[].resource.item[].item[].answerOption[].valueCoding.display
0. Continent - Complete control; DOES NOT USE any type of ostomy device

# entry[].resource.item[].item[].answerOption[].valueCoding.display
1. Control with ostomy - Control with ostomy over last 3 days

# entry[].resource.item[].item[].answerOption[].valueCoding.display
2. Infrequently incontinent - Not incontinent over last 3 days, but does have incontinent episodes

# entry[].resource.item[].item[].answerOption[].valueCoding.display
3. Occasionally incontinent — Less than daily

# entry[].resource.item[].item[].answerOption[].valueCoding.display
4. Frequently incontinent — Daily, but some control present

# entry[].resource.item[].item[].answerOption[].valueCoding.display
8. Did not occur — No bowel movement in last 3 days

# entry[].resource.item[].item[].item[].code[].display
a. Hip fracture during the last 30 days (or since last assessment if less than 30 days)

# entry[].resource.item[].item[].item[].text
a. Hip fracture during the last 30 days (or since last assessment if less than 30 days)

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Primary diagnosis / diagnoses for current stay

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
2. Diagnosis present, receiving active treatment

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Diagnosis present, monitored but no active treatment

# entry[].resource.item[].item[].item[].code[].display
b. Other fracture during the last 30 days (or since last assessment if less than 30 days)

# entry[].resource.item[].item[].item[].text
b. Other fracture during the last 30 days (or since last assessment if less than 30 days)

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Primary diagnosis / diagnoses for current stay

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
2. Diagnosis present, receiving active treatment

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Diagnosis present, monitored but no active treatment

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Primary diagnosis / diagnoses for current stay

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
2. Diagnosis present, receiving active treatment

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Diagnosis present, monitored but no active treatment

# entry[].resource.item[].item[].item[].code[].display
d. Dementia other than Alzheimer's disease

# entry[].resource.item[].item[].item[].text
d. Dementia other than Alzheimer's disease

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Primary diagnosis / diagnoses for current stay

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
2. Diagnosis present, receiving active treatment

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Diagnosis present, monitored but no active treatment

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Primary diagnosis / diagnoses for current stay

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
2. Diagnosis present, receiving active treatment

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Diagnosis present, monitored but no active treatment

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Primary diagnosis / diagnoses for current stay

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
2. Diagnosis present, receiving active treatment

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Diagnosis present, monitored but no active treatment

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Primary diagnosis / diagnoses for current stay

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
2. Diagnosis present, receiving active treatment

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Diagnosis present, monitored but no active treatment

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Primary diagnosis / diagnoses for current stay

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
2. Diagnosis present, receiving active treatment

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Diagnosis present, monitored but no active treatment

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Primary diagnosis / diagnoses for current stay

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
2. Diagnosis present, receiving active treatment

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Diagnosis present, monitored but no active treatment

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Primary diagnosis / diagnoses for current stay

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
2. Diagnosis present, receiving active treatment

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Diagnosis present, monitored but no active treatment

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Primary diagnosis / diagnoses for current stay

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
2. Diagnosis present, receiving active treatment

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Diagnosis present, monitored but no active treatment

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Primary diagnosis / diagnoses for current stay

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
2. Diagnosis present, receiving active treatment

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Diagnosis present, monitored but no active treatment

# entry[].resource.item[].item[].item[].code[].display
l. Chronic obstructive pulmonary disease (COPD)

# entry[].resource.item[].item[].item[].text
l. Chronic obstructive pulmonary disease (COPD)

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Primary diagnosis / diagnoses for current stay

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
2. Diagnosis present, receiving active treatment

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Diagnosis present, monitored but no active treatment

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Primary diagnosis / diagnoses for current stay

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
2. Diagnosis present, receiving active treatment

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Diagnosis present, monitored but no active treatment

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Primary diagnosis / diagnoses for current stay

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
2. Diagnosis present, receiving active treatment

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Diagnosis present, monitored but no active treatment

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Primary diagnosis / diagnoses for current stay

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
2. Diagnosis present, receiving active treatment

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Diagnosis present, monitored but no active treatment

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Primary diagnosis / diagnoses for current stay

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
2. Diagnosis present, receiving active treatment

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Diagnosis present, monitored but no active treatment

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Primary diagnosis / diagnoses for current stay

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
2. Diagnosis present, receiving active treatment

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Diagnosis present, monitored but no active treatment

# entry[].resource.item[].item[].item[].code[].display
s. Urinary tract infection (UTI) during last 30 days

# entry[].resource.item[].item[].item[].text
s. Urinary tract infection (UTI) during last 30 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Primary diagnosis / diagnoses for current stay

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
2. Diagnosis present, receiving active treatment

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Diagnosis present, monitored but no active treatment

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Primary diagnosis / diagnoses for current stay

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
2. Diagnosis present, receiving active treatment

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Diagnosis present, monitored but no active treatment

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Primary diagnosis / diagnoses for current stay

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
2. Diagnosis present, receiving active treatment

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Diagnosis present, monitored but no active treatment

# entry[].resource.item[].item[].item[].item[].answerOption[].valueCoding.display
1. Primary diagnosis / diagnoses for current stay

# entry[].resource.item[].item[].item[].item[].answerOption[].valueCoding.display
2. Diagnosis present, receiving active treatment

# entry[].resource.item[].item[].item[].item[].answerOption[].valueCoding.display
3. Diagnosis present, monitored but no active treatment

# entry[].resource.item[].item[].item[].item[].answerOption[].valueCoding.display
1. Primary diagnosis / diagnoses for current stay

# entry[].resource.item[].item[].item[].item[].answerOption[].valueCoding.display
2. Diagnosis present, receiving active treatment

# entry[].resource.item[].item[].item[].item[].answerOption[].valueCoding.display
3. Diagnosis present, monitored but no active treatment

# entry[].resource.item[].item[].item[].item[].answerOption[].valueCoding.display
1. Primary diagnosis / diagnoses for current stay

# entry[].resource.item[].item[].item[].item[].answerOption[].valueCoding.display
2. Diagnosis present, receiving active treatment

# entry[].resource.item[].item[].item[].item[].answerOption[].valueCoding.display
3. Diagnosis present, monitored but no active treatment

# entry[].resource.item[].item[].item[].item[].answerOption[].valueCoding.display
1. Primary diagnosis / diagnoses for current stay

# entry[].resource.item[].item[].item[].item[].answerOption[].valueCoding.display
2. Diagnosis present, receiving active treatment

# entry[].resource.item[].item[].item[].item[].answerOption[].valueCoding.display
3. Diagnosis present, monitored but no active treatment

# entry[].resource.item[].item[].item[].item[].answerOption[].valueCoding.display
1. Primary diagnosis / diagnoses for current stay

# entry[].resource.item[].item[].item[].item[].answerOption[].valueCoding.display
2. Diagnosis present, receiving active treatment

# entry[].resource.item[].item[].item[].item[].answerOption[].valueCoding.display
3. Diagnosis present, monitored but no active treatment

# entry[].resource.item[].item[].item[].item[].answerOption[].valueCoding.display
1. Primary diagnosis / diagnoses for current stay

# entry[].resource.item[].item[].item[].item[].answerOption[].valueCoding.display
2. Diagnosis present, receiving active treatment

# entry[].resource.item[].item[].item[].item[].answerOption[].valueCoding.display
3. Diagnosis present, monitored but no active treatment

# entry[].resource.item[].item[].answerOption[].valueCoding.display
1. No fall in the last 30 days, but fell 31-90 days ago

# entry[].resource.item[].item[].code[].display
RECENT FALLS - [Skip if last assessed more than 30 days ago or if this is first assessment]. Leave blank if 'Not applicable' (first assessment or more than 30 days since last assessment)

# entry[].resource.item[].item[].text
2. RECENT FALLS - [Skip if last assessed more than 30 days ago or if this is first assessment]. Leave blank if 'Not applicable' (first assessment or more than 30 days since last assessment)

# entry[].resource.item[].item[].item[].text
[Skip if last assessed more than 30 days ago or if this is first assessment]. Leave blank if 'Not applicable' (first assessment or more than 30 days since last assessment)

# entry[].resource.item[].item[].item[].code[].display
a. Difficult or unable to move self to standing position unassisted

# entry[].resource.item[].item[].item[].text
a. Difficult or unable to move self to standing position unassisted

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Present but not exhibited in last 3 days

# entry[].resource.item[].item[].item[].code[].display
b. Difficult or unable to turn self around and face the opposite direction when standing

# entry[].resource.item[].item[].item[].text
b. Difficult or unable to turn self around and face the opposite direction when standing

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Present but not exhibited in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Present but not exhibited in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Present but not exhibited in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Present but not exhibited in last 3 days

# entry[].resource.item[].item[].item[].code[].display
f. Difficulty clearing airway secretions

# entry[].resource.item[].item[].item[].text
f. Difficulty clearing airway secretions

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Present but not exhibited in last 3 days

# entry[].resource.item[].item[].item[].text
g. Abnormal thought process - e.g., loosening of associations, blocking, flight of ideas, tangentiality, circumstantiality

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Present but not exhibited in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Present but not exhibited in last 3 days

# entry[].resource.item[].item[].item[].text
i. Hallucinations - False sensory perceptions

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Present but not exhibited in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Present but not exhibited in last 3 days

# entry[].resource.item[].item[].item[].text
k. Acid reflux - Regurgitation of acid from stomach to throat

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Present but not exhibited in last 3 days

# entry[].resource.item[].item[].item[].text
l. Constipation - No bowel movement in 3 days or difficult passage of hard stool

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Present but not exhibited in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Present but not exhibited in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Present but not exhibited in last 3 days

# entry[].resource.item[].item[].item[].code[].display
o. Difficulty falling asleep or staying asleep; waking up too early; restless- ness; non-restful sleep

# entry[].resource.item[].item[].item[].text
o. Difficulty falling asleep or staying asleep; waking up too early; restless- ness; non-restful sleep

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Present but not exhibited in last 3 days

# entry[].resource.item[].item[].item[].code[].display
p. Too much sleep - Excessive amount of sleep that interferes with person’s normal functioning

# entry[].resource.item[].item[].item[].text
p. Too much sleep - Excessive amount of sleep that interferes with person’s normal functioning

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Present but not exhibited in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Present but not exhibited in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Present but not exhibited in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Present but not exhibited in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Present but not exhibited in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Present but not exhibited in last 3 days

# entry[].resource.item[].item[].answerOption[].valueCoding.display
1. Absent at rest but present when performed moderate activities

# entry[].resource.item[].item[].answerOption[].valueCoding.display
2. Absent at rest but present when performed normal day-to-day activities

# entry[].resource.item[].item[].code[].display
5. FATIGUE - Inability to complete normal daily activities - e.g., ADLs, IADLs

# entry[].resource.item[].item[].text
5. FATIGUE - Inability to complete normal daily activities - e.g., ADLs, IADLs

# entry[].resource.item[].item[].answerOption[].valueCoding.display
1. Minimal—Diminished energy but completes normal day-to-day activities

# entry[].resource.item[].item[].answerOption[].valueCoding.display
2. Moderate—Due to diminished energy, UNABLE TO FINISH normal day-to-day activities

# entry[].resource.item[].item[].answerOption[].valueCoding.display
3. Severe—Due to diminished energy, UNABLE TO START SOME normal day-to-day activities

# entry[].resource.item[].item[].answerOption[].valueCoding.display
4. Unable to commence any normal day-to-day activities—Due to diminished energy

# entry[].resource.item[].item[].item[].text
Inability to complete normal daily activities - e.g., ADLs, IADLs

# entry[].resource.item[].item[].item[].text
[Note: Always ask the person about pain frequency, intensity, and control. Observe person and ask others who are in contact with the person.]

# entry[].resource.item[].item[].item[].code[].display
a. Frequency with which person complains or shows evidence of pain

# entry[].resource.item[].item[].item[].text
a. Frequency with which person complains or shows evidence of pain (including grimacing, teeth clenching, moaning, withdrawal when touched, or other non-verbal signs suggesting pain)

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Present recently but not exhibited in last 3 days

# entry[].resource.item[].item[].item[].code[].display
b. Intensity of highest level of pain present

# entry[].resource.item[].item[].item[].text
b. Intensity of highest level of pain present

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
4. Times when pain is horrible or excruciating

# entry[].resource.item[].item[].item[].text
d. Breakthrough pain - Times in LAST 3 DAYS when person experienced sudden, acute flare-ups of pain

# entry[].resource.item[].item[].item[].text
e. Pain control - Adequacy of current therapeutic regimen to control pain (from person's point of view)

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Pain intensity acceptable to person; no treatment regimen or change in regimen required

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
2. Controlled adequately by therapeutic regimen

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Controlled when therapeutic regimen followed, but regimen not always followed as ordered

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
4. Therapeutic regimen followed, but pain control not adequate

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
5. No therapeutic regimen being followed for pain; pain not adequately controlled

# entry[].resource.item[].item[].item[].code[].display
a. Conditions/diseases make cognitive, AD, mood, or behaviour patterns unstable

# entry[].resource.item[].item[].item[].text
a. Conditions/diseases make cognitive, AD, mood, or behaviour patterns unstable

# entry[].resource.item[].item[].item[].code[].display
b. Experiencing an acute episode or flare up of a recurrent or chronic problem

# entry[].resource.item[].item[].item[].text
b. Experiencing an acute episode or flare up of a recurrent or chronic problem

# entry[].resource.item[].item[].item[].code[].display
c. End-stage disease, 6 or fewer months to live

# entry[].resource.item[].item[].item[].text
c. End-stage disease, 6 or fewer months to live

# entry[].resource.item[].item[].code[].display
SELF-REPORTED HEALTH - Ask: "In general, how would you rate your health?"

# entry[].resource.item[].item[].text
8. SELF-REPORTED HEALTH - Ask: "In general, how would you rate your health?"

# entry[].resource.item[].item[].item[].text
Ask: "In general, how would you rate your health?"

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Not in last 3 days but is usually a daily smoker

# entry[].resource.item[].item[].item[].text
b. Alcohol-Highest number of drinks in any 'single sitting' in LAST 14 DAYS

# entry[].resource.item[].item[].item[].text
"Record (a.) height in centimetres and (b.) weight in kilograms. Base weight on most recent measure in LAST 30 DAYS."

# entry[].resource.item[].item[].item[].code[].display
a. Weight loss of 5% or more in LAST 30 DAYS, or 10% or more in LAST 180 DAYS

# entry[].resource.item[].item[].item[].text
a. Weight loss of 5% or more in LAST 30 DAYS, or 10% or more in LAST 180 DAYS

# entry[].resource.item[].item[].item[].code[].display
c. Fluid intake less than 1,000ml per day

# entry[].resource.item[].item[].item[].text
c. Fluid intake less than 1,000ml per day

# entry[].resource.item[].item[].answerOption[].valueCoding.display
1. Modified independent—e.g., liquid is sipped, takes limited solid food; need for modification may be unknown

# entry[].resource.item[].item[].answerOption[].valueCoding.display
2. Requires diet modification to swallow solid food—e.g., mechanical diet (puree, minced, etc.) or only able to ingest specific foods

# entry[].resource.item[].item[].answerOption[].valueCoding.display
3. Requires modification to swallow liquids—e.g., thickened liquids

# entry[].resource.item[].item[].answerOption[].valueCoding.display
4. Can swallow only pureed solids AND thickened liquids

# entry[].resource.item[].item[].answerOption[].valueCoding.display
5. Combined oral and parenteral or oral and tube feeding

# entry[].resource.item[].item[].answerOption[].valueCoding.display
7. Abdominal feeding tube only—e.g., PEG tube

# entry[].resource.item[].item[].answerOption[].valueCoding.display
8. Parenteral feeding only—Includes all types of parenteral feedings, such as total parenteral nutrition (TPN)

# entry[].resource.item[].item[].answerOption[].valueCoding.display
9. Activity did not occur—During entire period

# entry[].resource.item[].item[].code[].display
PARENTERAL OR ENTERAL INTAKE - The proportion of TOTAL CALORIES received through parenteral or tube feedings in the LAST 3 DAYS

# entry[].resource.item[].item[].text
4. PARENTERAL OR ENTERAL INTAKE - The proportion of TOTAL CALORIES received through parenteral or tube feedings in the LAST 3 DAYS

# entry[].resource.item[].item[].answerOption[].valueCoding.display
1. Parenteral / enteral tube, but no caloric intake

# entry[].resource.item[].item[].answerOption[].valueCoding.display
2. 1–25% of total calories through device

# entry[].resource.item[].item[].answerOption[].valueCoding.display
3. 26% or more of total calories through device

# entry[].resource.item[].item[].item[].text
The proportion of TOTAL CALORIES received through parenteral or tube feedings in the LAST 3 DAYS

# entry[].resource.item[].item[].item[].code[].display
a. Wears a denture (removable prosthesis)

# entry[].resource.item[].item[].item[].text
a. Wears a denture (removable prosthesis)

# entry[].resource.item[].item[].item[].code[].display
b. Has broken, fragmented, loose, or otherwise nonintact natural teeth

# entry[].resource.item[].item[].item[].text
b. Has broken, fragmented, loose, or otherwise nonintact natural teeth

# entry[].resource.item[].item[].item[].code[].display
c. Reports mouth or facial pain / discomfort

# entry[].resource.item[].item[].item[].text
c. Reports mouth or facial pain / discomfort

# entry[].resource.item[].item[].item[].code[].display
f. Presents with gum (soft tissue) inflammation or bleeding adjacent to natural teeth or tooth fragments

# entry[].resource.item[].item[].item[].text
f. Presents with gum (soft tissue) inflammation or bleeding adjacent to natural teeth or tooth fragments

# entry[].resource.item[].item[].answerOption[].valueCoding.display
4. Breaks in skin exposing muscle or bone

# entry[].resource.item[].item[].answerOption[].valueCoding.display
5. Not codeable—necrotic eschar predominant

# entry[].resource.item[].item[].answerOption[].valueCoding.display
6. Not codeable—suspected deep tissue injury, depth unknown

# entry[].resource.item[].item[].code[].display
Presence of skin ulcer other than pressure ulcer - e.g., venous ulcer, arterial ulcer, mixed venous-arterial ulcer, diabetic foot ulcer

# entry[].resource.item[].item[].text
3. Presence of skin ulcer other than pressure ulcer - e.g., venous ulcer, arterial ulcer, mixed venous-arterial ulcer, diabetic foot ulcer

# entry[].resource.item[].item[].code[].display
4. Major skin problems - e.g., lesions, 2nd- or 3rd-degree burns, healing surgical wounds

# entry[].resource.item[].item[].text
4. Major skin problems - e.g., lesions, 2nd- or 3rd-degree burns, healing surgical wounds

# entry[].resource.item[].item[].text
5. Skin tears or cuts - other than surgery

# entry[].resource.item[].item[].code[].display
Other skin conditions or changes in skin condition

# entry[].resource.item[].item[].text
6. Other skin conditions or changes in skin condition - e.g., bruises, rashes, itching, mottling, herpes zoster, intertrigo, eczema

# entry[].resource.item[].item[].code[].display
Foot problems - e.g., bunions, hammertoes, overlapping toes, structural problems, infections, ulcers

# entry[].resource.item[].item[].text
7. Foot problems - e.g., bunions, hammertoes, overlapping toes, structural problems, infections, ulcers

# entry[].resource.item[].item[].answerOption[].valueCoding.display
1. Foot problems, no limitation in walking

# entry[].resource.item[].item[].answerOption[].valueCoding.display
4. Foot problems; does not walk for other reasons

# entry[].resource.item[].item[].code[].display
Average time involved in activities - e.g., alone, in social group. [Note: When awake and not receiving treatments or ADL care]

# entry[].resource.item[].item[].text
1. Average time involved in activities - e.g., alone, in social group. [Note: When awake and not receiving treatments or ADL care]

# entry[].resource.item[].item[].code[].display
2. Activity preferences and involvement (Adapted to current abilities)

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
0. No preference, not involved in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. No preference, involved in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Preferred, regularly involved but not in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
0. No preference, not involved in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. No preference, involved in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Preferred, regularly involved but not in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
0. No preference, not involved in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. No preference, involved in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Preferred, regularly involved but not in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
0. No preference, not involved in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. No preference, involved in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Preferred, regularly involved but not in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
0. No preference, not involved in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. No preference, involved in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Preferred, regularly involved but not in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
0. No preference, not involved in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. No preference, involved in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Preferred, regularly involved but not in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
0. No preference, not involved in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. No preference, involved in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Preferred, regularly involved but not in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
0. No preference, not involved in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. No preference, involved in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Preferred, regularly involved but not in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
0. No preference, not involved in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. No preference, involved in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Preferred, regularly involved but not in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
0. No preference, not involved in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. No preference, involved in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Preferred, regularly involved but not in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
0. No preference, not involved in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. No preference, involved in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Preferred, regularly involved but not in last 3 days

# entry[].resource.item[].item[].item[].code[].display
l. Reading, writing, or crossword puzzles

# entry[].resource.item[].item[].item[].text
l. Reading, writing, or crossword puzzles

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
0. No preference, not involved in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. No preference, involved in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Preferred, regularly involved but not in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
0. No preference, not involved in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. No preference, involved in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Preferred, regularly involved but not in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
0. No preference, not involved in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. No preference, involved in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Preferred, regularly involved but not in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
0. No preference, not involved in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. No preference, involved in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Preferred, regularly involved but not in last 3 days

# entry[].resource.item[].item[].item[].code[].display
p. Watching television, listening to radio, listening to music

# entry[].resource.item[].item[].item[].text
p. Watching television, listening to radio, listening to music

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
0. No preference, not involved in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. No preference, involved in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Preferred, regularly involved but not in last 3 days

# entry[].resource.item[].item[].answerOption[].valueCoding.display
0. Awake all or most of the time (no more than one nap in the morning or afternoon)

# entry[].resource.item[].item[].answerOption[].valueCoding.display
2. Asleep most of the time, but some periods awake and alert (e.g., at meals)

# entry[].resource.item[].item[].item[].text
"List all active prescriptions, and any non-prescribed (over-the-counter) medications taken in the LAST 3 DAYS [Note: Use computerized records if possible, hand enter only when absolutely necessary.] For each drug record a - g:"

# entry[].resource.item[].item[].item[].item[].text
b. Dose - A positive number such as 0.5, 5, 150, 300.

# entry[].resource.item[].item[].item[].item[].item[].text
[Note: Never write a zero by itself after a decimal point (X mg). Always use a zero before a decimal point (0.X mg).]

# entry[].resource.item[].item[].item[].item[].text
c. Unit - Code using the following list:

# entry[].resource.item[].item[].item[].item[].text
d. Route of administration - Code using the following list:

# entry[].resource.item[].item[].item[].item[].text
e. Frequency - Code the number of times per day, week, or month the medication is administered using the following list:

# entry[].resource.item[].item[].item[].item[].answerOption[].valueCoding.display
BID (2 times daily; including every 12 hours)

# entry[].resource.item[].item[].item[].item[].text
b. Dose - A positive number such as 0.5, 5, 150, 300.

# entry[].resource.item[].item[].item[].item[].item[].text
[Note: Never write a zero by itself after a decimal point (X mg). Always use a zero before a decimal point (0.X mg).]

# entry[].resource.item[].item[].item[].item[].text
c. Unit - Code using the following list:

# entry[].resource.item[].item[].item[].item[].text
d. Route of administration - Code using the following list:

# entry[].resource.item[].item[].item[].item[].text
e. Frequency - Code the number of times per day, week, or month the medication is administered using the following list:

# entry[].resource.item[].item[].item[].item[].answerOption[].valueCoding.display
BID (2 times daily; including every 12 hours)

# entry[].resource.item[].item[].item[].item[].text
b. Dose - A positive number such as 0.5, 5, 150, 300.

# entry[].resource.item[].item[].item[].item[].item[].text
[Note: Never write a zero by itself after a decimal point (X mg). Always use a zero before a decimal point (0.X mg).]

# entry[].resource.item[].item[].item[].item[].text
c. Unit - Code using the following list:

# entry[].resource.item[].item[].item[].item[].text
d. Route of administration - Code using the following list:

# entry[].resource.item[].item[].item[].item[].text
e. Frequency - Code the number of times per day, week, or month the medication is administered using the following list:

# entry[].resource.item[].item[].item[].item[].answerOption[].valueCoding.display
BID (2 times daily; including every 12 hours)

# entry[].resource.item[].item[].item[].item[].text
b. Dose - A positive number such as 0.5, 5, 150, 300.

# entry[].resource.item[].item[].item[].item[].item[].text
[Note: Never write a zero by itself after a decimal point (X mg). Always use a zero before a decimal point (0.X mg).]

# entry[].resource.item[].item[].item[].item[].text
c. Unit - Code using the following list:

# entry[].resource.item[].item[].item[].item[].text
d. Route of administration - Code using the following list:

# entry[].resource.item[].item[].item[].item[].text
e. Frequency - Code the number of times per day, week, or month the medication is administered using the following list:

# entry[].resource.item[].item[].item[].item[].answerOption[].valueCoding.display
BID (2 times daily; including every 12 hours)

# entry[].resource.item[].item[].item[].item[].text
b. Dose - A positive number such as 0.5, 5, 150, 300.

# entry[].resource.item[].item[].item[].item[].item[].text
[Note: Never write a zero by itself after a decimal point (X mg). Always use a zero before a decimal point (0.X mg).]

# entry[].resource.item[].item[].item[].item[].text
c. Unit - Code using the following list:

# entry[].resource.item[].item[].item[].item[].text
d. Route of administration - Code using the following list:

# entry[].resource.item[].item[].item[].item[].text
e. Frequency - Code the number of times per day, week, or month the medication is administered using the following list:

# entry[].resource.item[].item[].item[].item[].answerOption[].valueCoding.display
BID (2 times daily; including every 12 hours)

# entry[].resource.item[].item[].item[].item[].text
b. Dose - A positive number such as 0.5, 5, 150, 300.

# entry[].resource.item[].item[].item[].item[].item[].text
[Note: Never write a zero by itself after a decimal point (X mg). Always use a zero before a decimal point (0.X mg).]

# entry[].resource.item[].item[].item[].item[].text
c. Unit - Code using the following list:

# entry[].resource.item[].item[].item[].item[].text
d. Route of administration - Code using the following list:

# entry[].resource.item[].item[].item[].item[].text
e. Frequency - Code the number of times per day, week, or month the medication is administered using the following list:

# entry[].resource.item[].item[].item[].item[].answerOption[].valueCoding.display
BID (2 times daily; including every 12 hours)

# entry[].resource.item[].item[].item[].item[].text
b. Dose - A positive number such as 0.5, 5, 150, 300.

# entry[].resource.item[].item[].item[].item[].item[].text
[Note: Never write a zero by itself after a decimal point (X mg). Always use a zero before a decimal point (0.X mg).]

# entry[].resource.item[].item[].item[].item[].text
c. Unit - Code using the following list:

# entry[].resource.item[].item[].item[].item[].text
d. Route of administration - Code using the following list:

# entry[].resource.item[].item[].item[].item[].text
e. Frequency - Code the number of times per day, week, or month the medication is administered using the following list:

# entry[].resource.item[].item[].item[].item[].answerOption[].valueCoding.display
BID (2 times daily; including every 12 hours)

# entry[].resource.item[].item[].item[].item[].text
b. Dose - A positive number such as 0.5, 5, 150, 300.

# entry[].resource.item[].item[].item[].item[].item[].text
[Note: Never write a zero by itself after a decimal point (X mg). Always use a zero before a decimal point (0.X mg).]

# entry[].resource.item[].item[].item[].item[].text
c. Unit - Code using the following list:

# entry[].resource.item[].item[].item[].item[].text
d. Route of administration - Code using the following list:

# entry[].resource.item[].item[].item[].item[].text
e. Frequency - Code the number of times per day, week, or month the medication is administered using the following list:

# entry[].resource.item[].item[].item[].item[].answerOption[].valueCoding.display
BID (2 times daily; including every 12 hours)

# entry[].resource.item[].item[].item[].item[].text
b. Dose - A positive number such as 0.5, 5, 150, 300.

# entry[].resource.item[].item[].item[].item[].item[].text
[Note: Never write a zero by itself after a decimal point (X mg). Always use a zero before a decimal point (0.X mg).]

# entry[].resource.item[].item[].item[].item[].text
c. Unit - Code using the following list:

# entry[].resource.item[].item[].item[].item[].text
d. Route of administration - Code using the following list:

# entry[].resource.item[].item[].item[].item[].text
e. Frequency - Code the number of times per day, week, or month the medication is administered using the following list:

# entry[].resource.item[].item[].item[].item[].answerOption[].valueCoding.display
BID (2 times daily; including every 12 hours)

# entry[].resource.item[].item[].item[].item[].text
b. Dose - A positive number such as 0.5, 5, 150, 300.

# entry[].resource.item[].item[].item[].item[].item[].text
[Note: Never write a zero by itself after a decimal point (X mg). Always use a zero before a decimal point (0.X mg).]

# entry[].resource.item[].item[].item[].item[].text
c. Unit - Code using the following list:

# entry[].resource.item[].item[].item[].item[].text
d. Route of administration - Code using the following list:

# entry[].resource.item[].item[].item[].item[].text
e. Frequency - Code the number of times per day, week, or month the medication is administered using the following list:

# entry[].resource.item[].item[].item[].item[].answerOption[].valueCoding.display
BID (2 times daily; including every 12 hours)

# entry[].resource.item[].item[].item[].item[].text
b. Dose - A positive number such as 0.5, 5, 150, 300.

# entry[].resource.item[].item[].item[].item[].item[].text
[Note: Never write a zero by itself after a decimal point (X mg). Always use a zero before a decimal point (0.X mg).]

# entry[].resource.item[].item[].item[].item[].text
c. Unit - Code using the following list:

# entry[].resource.item[].item[].item[].item[].text
d. Route of administration - Code using the following list:

# entry[].resource.item[].item[].item[].item[].text
e. Frequency - Code the number of times per day, week, or month the medication is administered using the following list:

# entry[].resource.item[].item[].item[].item[].answerOption[].valueCoding.display
BID (2 times daily; including every 12 hours)

# entry[].resource.item[].item[].item[].item[].text
b. Dose - A positive number such as 0.5, 5, 150, 300.

# entry[].resource.item[].item[].item[].item[].item[].text
[Note: Never write a zero by itself after a decimal point (X mg). Always use a zero before a decimal point (0.X mg).]

# entry[].resource.item[].item[].item[].item[].text
c. Unit - Code using the following list:

# entry[].resource.item[].item[].item[].item[].text
d. Route of administration - Code using the following list:

# entry[].resource.item[].item[].item[].item[].text
e. Frequency - Code the number of times per day, week, or month the medication is administered using the following list:

# entry[].resource.item[].item[].item[].item[].answerOption[].valueCoding.display
BID (2 times daily; including every 12 hours)

# entry[].resource.item[].item[].item[].text
"[Note: Add additional lines, as necessary, for other drugs taken] [Abbreviations are country-specific for Unit, Route, Frequency]"

# entry[].resource.item[].item[].item[].text
g. Mammogram or breast exam in LAST 2 YEARS (for women)

# entry[].resource.item[].item[].item[].code[].display
h. Pneumovax vaccine in last 5 years or after age 65

# entry[].resource.item[].item[].item[].text
h. Pneumovax vaccine in LAST 5 YEARS or after age 65

# entry[].resource.item[].item[].code[].display
2. Treatments and programs received or scheduled in the last 3 days (or since last assessment if less than 3 days)

# entry[].resource.item[].item[].text
2. Treatments and programs received or scheduled in the last 3 days (or since last assessment if less than 3 days)

# entry[].resource.item[].item[].item[].code[].display
c. Infection control — e.g., isolation, quarantine

# entry[].resource.item[].item[].item[].text
c. Infection control — e.g., isolation, quarantine

# entry[].resource.item[].item[].item[].code[].display
m. Palliative care for chronic conditions

# entry[].resource.item[].item[].item[].text
m. Palliative care for chronic conditions

# entry[].resource.item[].item[].code[].display
3. Therapy/Nursing services in last 7 days - e.g., therapist or therapy assistant under direction of therapist

# entry[].resource.item[].item[].text
3. Therapy/Nursing services in last 7 days - e.g., therapist or therapy assistant under direction of therapist

# entry[].resource.item[].item[].item[].item[].code[].display
Physical therapy - days treatment scheduled

# entry[].resource.item[].item[].item[].item[].text
Physical therapy - Number of days treatment scheduled in the LAST 7 DAYS

# entry[].resource.item[].item[].item[].item[].code[].display
Physical therapy - days treatment administered

# entry[].resource.item[].item[].item[].item[].text
Physical therapy - Number of days treatment administered for 15 minutes or more

# entry[].resource.item[].item[].item[].item[].code[].display
Physical therapy - minutes treatment administered or ordered

# entry[].resource.item[].item[].item[].item[].text
Physical therapy - Total number of minutes provided in LAST 7 DAYS (or ordered if days administered = 0 and days scheduled > 0)

# entry[].resource.item[].item[].item[].item[].code[].display
Occupational therapy - days treatment scheduled

# entry[].resource.item[].item[].item[].item[].code[].display
Physical therapy - days treatment scheduled

# entry[].resource.item[].item[].item[].item[].text
Occupational therapy - Number of days treatment scheduled in the LAST 7 DAYS

# entry[].resource.item[].item[].item[].item[].code[].display
Occupational therapy - days treatment administered

# entry[].resource.item[].item[].item[].item[].code[].display
Physical therapy - days treatment administered

# entry[].resource.item[].item[].item[].item[].text
Occupational therapy - Number of days treatment administered for 15 minutes or more

# entry[].resource.item[].item[].item[].item[].code[].display
Occupational therapy - minutes treatment administered or ordered

# entry[].resource.item[].item[].item[].item[].code[].display
Physical therapy - minutes treatment administered or ordered

# entry[].resource.item[].item[].item[].item[].text
Occupational therapy - Total number of minutes provided in LAST 7 DAYS (or ordered if days administered = 0 and days scheduled > 0)

# entry[].resource.item[].item[].item[].code[].display
c. Speech-Language Therapy and Audiology Services

# entry[].resource.item[].item[].item[].text
c. Speech-Language Therapy and Audiology Services

# entry[].resource.item[].item[].item[].item[].code[].display
Speech-Language Therapy and Audiology Services - days treatment scheduled

# entry[].resource.item[].item[].item[].item[].code[].display
Physical therapy - days treatment scheduled

# entry[].resource.item[].item[].item[].item[].text
Speech-language pathology and audiology services - Number of days treatment scheduled in the LAST 7 DAYS

# entry[].resource.item[].item[].item[].item[].code[].display
Speech-Language Therapy and Audiology Services - days treatment administered

# entry[].resource.item[].item[].item[].item[].code[].display
Physical therapy - days treatment administered

# entry[].resource.item[].item[].item[].item[].text
Speech-Language Therapy and Audiology Services - Number of days treatment administered for 15 minutes or more

# entry[].resource.item[].item[].item[].item[].code[].display
Speech-Language Therapy and Audiology Services - minutes treatment administered or ordered

# entry[].resource.item[].item[].item[].item[].code[].display
Physical therapy - minutes treatment administered or ordered

# entry[].resource.item[].item[].item[].item[].text
Speech-Language Therapy and Audiology Services - Total number of minutes provided in LAST 7 DAYS (or ordered if days administered = 0 and days scheduled > 0)

# entry[].resource.item[].item[].item[].item[].code[].display
Respiratory therapy - days treatment scheduled

# entry[].resource.item[].item[].item[].item[].code[].display
Physical therapy - days treatment scheduled

# entry[].resource.item[].item[].item[].item[].text
Respiratory therapy - Number of days treatment scheduled in the LAST 7 DAYS

# entry[].resource.item[].item[].item[].item[].code[].display
Respiratory therapy - days treatment administered

# entry[].resource.item[].item[].item[].item[].code[].display
Physical therapy - days treatment administered

# entry[].resource.item[].item[].item[].item[].text
Respiratory therapy - Number of days treatment administered for 15 minutes or more

# entry[].resource.item[].item[].item[].item[].code[].display
Respiratory therapy - minutes treatment administered or ordered

# entry[].resource.item[].item[].item[].item[].code[].display
Physical therapy - minutes treatment administered or ordered

# entry[].resource.item[].item[].item[].item[].text
Respiratory therapy - Total number of minutes provided in LAST 7 DAYS (or ordered if days administered = 0 and days scheduled > 0)

# entry[].resource.item[].item[].item[].code[].display
e. Functional rehabilitation or walking program by licensed nurse

# entry[].resource.item[].item[].item[].text
e. Functional rehabilitation or walking program by licensed nurse

# entry[].resource.item[].item[].item[].item[].code[].display
Functional rehabilitation - days treatment scheduled

# entry[].resource.item[].item[].item[].item[].code[].display
Physical therapy - days treatment scheduled

# entry[].resource.item[].item[].item[].item[].text
Functional rehabilitation - Number of days treatment scheduled in the LAST 7 DAYS

# entry[].resource.item[].item[].item[].item[].code[].display
Functional rehabilitation - days treatment administered

# entry[].resource.item[].item[].item[].item[].code[].display
Physical therapy - days treatment administered

# entry[].resource.item[].item[].item[].item[].text
Functional rehabilitation - Number of days treatment administered for 15 minutes or more

# entry[].resource.item[].item[].item[].item[].code[].display
Functional rehabilitation - minutes treatment administered or ordered

# entry[].resource.item[].item[].item[].item[].code[].display
Physical therapy - minutes treatment administered or ordered

# entry[].resource.item[].item[].item[].item[].text
Functional rehabilitation - Total number of minutes provided in LAST 7 DAYS (or ordered if days administered = 0 and days scheduled > 0)

# entry[].resource.item[].item[].item[].item[].code[].display
Psychological therapy - days treatment scheduled

# entry[].resource.item[].item[].item[].item[].code[].display
Physical therapy - days treatment scheduled

# entry[].resource.item[].item[].item[].item[].text
Psychological therapies - Number of days treatment scheduled in the LAST 7 DAYS

# entry[].resource.item[].item[].item[].item[].code[].display
Psychological therapy - days treatment administered

# entry[].resource.item[].item[].item[].item[].code[].display
Physical therapy - days treatment administered

# entry[].resource.item[].item[].item[].item[].text
Psychological therapies - Number of days treatment administered for 15 minutes or more

# entry[].resource.item[].item[].item[].item[].code[].display
Psychological therapy - minutes treatment administered or ordered

# entry[].resource.item[].item[].item[].item[].code[].display
Physical therapy - minutes treatment administered or ordered

# entry[].resource.item[].item[].item[].item[].text
Psychological therapies - Total number of minutes provided in LAST 7 DAYS (or ordered if days administered = 0 and days scheduled > 0)

# entry[].resource.item[].item[].item[].text
Code for number of times in LAST 90 DAYS (or since last assessment if LESS THAN 90 DAYS)

# entry[].resource.item[].item[].item[].code[].display
a. In-patient acute care hospital with overnight stay

# entry[].resource.item[].item[].item[].text
a. In-patient acute care hospital with overnight stay

# entry[].resource.item[].item[].item[].code[].display
b. Emergency room / department visit (not counting overnight stay)

# entry[].resource.item[].item[].item[].text
b. Emergency room / department visit (not counting overnight stay)

# entry[].resource.item[].item[].code[].display
5. PHYSICIAN VISITS - Number of days in LAST 14 DAYS (or since admission if less than 14 days in facility) physician examined person. Include authorized assistant or practitioner. Enter 0 if none.

# entry[].resource.item[].item[].text
5. PHYSICIAN VISITS - Number of days in LAST 14 DAYS (or since admission if less than 14 days in facility) physician examined person. Include authorized assistant or practitioner. Enter 0 if none.

# entry[].resource.item[].item[].item[].text
"Number of days in LAST 14 DAYS (or since admission if less than 14 days in facility) physician examined person. Include authorized assistant or practitioner. Enter 0 if none."

# entry[].resource.item[].item[].code[].display
6. PHYSICIAN ORDERS - Number of days in LAST 14 DAYS (or since admission if less than 14 days in facility) physician changed person's orders. Include authorized assistant or practitioner. Do not include order renewals without changes. Enter 0 if none.

# entry[].resource.item[].item[].text
6. PHYSICIAN ORDERS - Number of days in LAST 14 DAYS (or since admission if less than 14 days in facility) physician changed person's orders. Include authorized assistant or practitioner. Do not include order renewals without changes. Enter 0 if none.

# entry[].resource.item[].item[].item[].text
"Number of days in LAST 14 DAYS (or since admission if less than 14 days in facility) physician changed person's orders. Include authorized assistant or practitioner. Do not include order renewals without changes. Enter 0 if none."

# entry[].resource.item[].item[].item[].code[].display
a. Full bed rails on all open sides of bed

# entry[].resource.item[].item[].item[].text
a. Full bed rails on all open sides of bed

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
4. Used nights and days, but not constant

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
5. Constant use for full 24 hours (may include periodic releases)

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
4. Used nights and days, but not constant

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
5. Constant use for full 24 hours (may include periodic releases)

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
4. Used nights and days, but not constant

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
5. Constant use for full 24 hours (may include periodic releases)

# entry[].resource.item[].code[].display
SECTION P. Responsibility and Directives

# entry[].resource.item[].text
SECTION P. Responsibility and Directives

# entry[].resource.item[].item[].item[].code[].display
c. Enduring power of attorney / health care

# entry[].resource.item[].item[].item[].text
c. Enduring power of attorney / health care

# entry[].resource.item[].item[].item[].code[].display
d. Enduring power of attorney / financial

# entry[].resource.item[].item[].item[].text
d. Enduring power of attorney / financial

# entry[].resource.item[].item[].item[].code[].display
a. Advance directives for not resuscitating

# entry[].resource.item[].item[].item[].text
a. Advance directives for not resuscitating

# entry[].resource.item[].item[].item[].code[].display
b. Advance directives for not intubating

# entry[].resource.item[].item[].item[].text
b. Advance directives for not intubating

# entry[].resource.item[].item[].item[].code[].display
c. Advance directives for not hospitalizing

# entry[].resource.item[].item[].item[].text
c. Advance directives for not hospitalizing

# entry[].resource.item[].item[].item[].code[].display
d. Advance directives for no tube feeding

# entry[].resource.item[].item[].item[].text
d. Advance directives for no tube feeding

# entry[].resource.item[].item[].item[].code[].display
e. Advance directives for medication restrictions

# entry[].resource.item[].item[].item[].text
e. Advance directives for medication restrictions

# entry[].resource.item[].item[].item[].code[].display
f. Advance directives for other treatment restrictions

# entry[].resource.item[].item[].item[].text
f. Advance directives for other treatment restrictions

# entry[].resource.item[].item[].item[].code[].display
g. Advance directives for comfort measures only

# entry[].resource.item[].item[].item[].text
g. Advance directives for comfort measures only

# entry[].resource.item[].item[].item[].code[].display
a. Expresses / indicates preference to return to or remain in community

# entry[].resource.item[].item[].item[].text
a. Expresses / indicates preference to return to or remain in community

# entry[].resource.item[].item[].item[].code[].display
b. Has a support person who is positive toward discharge or maintaining residence in community

# entry[].resource.item[].item[].item[].text
b. Has a support person who is positive toward discharge or maintaining residence in community

# entry[].resource.item[].item[].code[].display
How long person is expected to stay in the current setting or under the care of this service prior to discharge to community

# entry[].resource.item[].item[].text
2. How long person is expected to stay in the current setting or under the care of this service prior to discharge to community (count from assessment reference date, including that day)

# entry[].resource.item[].item[].text
2. Residential/Living status after discharge

# entry[].resource.item[].item[].answerOption[].valueCoding.display
1. Private residence - owned/purchasing - Client owns/is purchasing - Family member or related person owns/is purchasing

# entry[].resource.item[].item[].answerOption[].valueCoding.display
3. Private residence - public rental or community housing; indigenous community / settlement

# entry[].resource.item[].item[].answerOption[].valueCoding.display
4. Independent living within retirement village

# entry[].resource.item[].item[].answerOption[].valueCoding.display
5. Boarding house / rooming house / private hostel

# entry[].resource.item[].item[].answerOption[].valueCoding.display
7. Short-term crisis, emergency, or transactional accommodation

# entry[].resource.item[].item[].answerOption[].valueCoding.display
8. Mental health residence—e.g., psychiatric group home

# entry[].resource.item[].item[].answerOption[].valueCoding.display
9. Group home for persons with physical disability

# entry[].resource.item[].item[].answerOption[].valueCoding.display
10. Setting for persons with intellectual disability

# entry[].resource.item[].item[].answerOption[].valueCoding.display
11. Residential aged care service - low-level care

# entry[].resource.item[].item[].answerOption[].valueCoding.display
12. Residential aged care service - high-level care

# entry[].resource.item[].item[].answerOption[].valueCoding.display
14. Hospice facility / palliative care unit

# entry[].resource.item[].item[].code[].display
Scheduled to receive home care services at discharge

# entry[].resource.item[].item[].text
3. Scheduled to receive home care services at discharge

# entry[].resource.item[].item[].code[].display
Signature of person coordinating/completing the assessment

# entry[].resource.item[].item[].text
1. Signature of person coordinating/completing the assessment

# entry[].resource.contained[].description
Preferred value set for Condition Clinical Status.

# entry[].resource.extension[].extension[].valueString
The patient that is to be used to pre-populate the form

# entry[].resource.extension[].extension[].valueString
The practitioner user that is to be used to pre-populate the form

# entry[].resource.item[].item[].item[].text
Pulses (Bounding +++, Normal ++, Diminished +, Absent 0)

# entry[].resource.item[].item[].item[].text
Ankle Brachial Index (ABI) (This must be known prior to compression bandaging)

# entry[].resource.contained[].description
Preferred value set for Condition Clinical Status.

# entry[].resource.extension[].extension[].valueString
The patient that is to be used to pre-populate the form

# entry[].resource.extension[].extension[].valueString
The practitioner user that is to be used to pre-populate the form

# entry[].resource.item[].text
Pain measure (Without upper, lower bounds and step values)

# entry[].resource.extension[].extension[].valueString
The encounter that is to be used to pre-populate the form

# entry[].resource.extension[].extension[].valueString
The patient that is to be used to pre-populate the form

# entry[].resource.extension[].extension[].valueString
The patient that is to be used to pre-populate the form

# entry[].resource.extension[].extension[].valueString
The practitioner user that is to be used to pre-populate the form

# entry[].resource.copyright
CSIRO © 2022+; Licensed under Apache License, Version 2.0

# entry[].resource.item[].extension[].valueExpression.expression
iif(%patient.gender = 'unknown' or %patient.gender.empty(), 9, 0)

# entry[].resource.item[].item[].item[].item[].text
Use this item to represent the examination procedure as a single field.

# entry[].resource.item[].item[].item[].item[]._text.extension[].valueString
Use this item to represent the examination procedure as a single field.

# entry[].resource.item[].item[].item[].item[].text
Use this groups of items to represent the examination procedure as multiple components.

# entry[].resource.item[].item[].item[].item[]._text.extension[].valueString
Use this groups of items to represent the examination procedure as multiple components.

# entry[].resource.item[].item[].item[]._text.extension[].valueString
Total Score

# entry[].resource.item[].item[].item[].item[].extension[].valueCodeableConcept.text
A control where an axis is displayed between the high and low values and the control can be visually manipulated to select a value anywhere on the axis.

# entry[].resource.item[].item[].item[].item[].extension[].valueCodeableConcept.text
A control where an axis is displayed between the high and low values and the control can be visually manipulated to select a value anywhere on the axis.

# entry[].resource.item[].extension[].valueExpression.expression
%mentalscore + %historyscore + %visionscore + %toiletingscore + %transferscore + %mobilityscore

# entry[].resource.item[].item[].item[].text
Did the patient present to hospital with a fall or have they had a fall since admission?

# entry[].resource.item[].item[].item[].text
Has the patient fallen in the last 6 months?

# entry[].resource.item[].item[].item[].text
Does the patient require eyeglasses continually?

# entry[].resource.item[].item[].item[].text
Does the patient have glaucoma, cataracts or macular degeneration?

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
Complete Independence and Modified Independence - use of aids to be independent is allowed

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
Distant Supervision - one person easily or needs supervision for safety

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
Close Supervision - one strong skilled helper or two staff; physically can sit

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
Unable - no sitting balance, mechanical lift

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
Complete Independence and Modified Independence - may use any aid, e.g. walking stick

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
Distant Supervision - walks with help of one person (verbal or physical)

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
Close Supervision - eyes on and hands ready at all times

# entry[].resource.item[].item[].code[].display
Anatomical location of macroscopically extent of invasion

# entry[].resource.item[].item[].text
Anatomical location of macroscopically extent of invasion

# entry[].resource.item[].item[].answerOption[].valueCoding.display
Involvement of other adjacent structures

# entry[].resource.item[].item[].item[].code[].display
Specified location of macroscopically extent of invasion

# entry[].resource.item[].item[].item[].text
Specified location of macroscopically extent of invasion

# entry[].resource.item[].item[].item[].enableWhen[].answerCoding.display
Involvement of other adjacent structures

# entry[].resource.item[].item[].code[].display
Histological type of non-invasive carcinoma

# entry[].resource.item[].item[].text
Histological type of non-invasive carcinoma

# entry[].resource.item[].item[].item[].text
Other histological type of non-invasive carcinoma

# entry[].resource.item[].item[].code[].display
Histological grade of urothelial carcinoma

# entry[].resource.item[].item[].text
Histological grade of urothelial carcinoma

# entry[].resource.item[].item[].code[].display
Histological grade of squamous cell carcinoma or adenocarcinoma

# entry[].resource.item[].item[].text
Histological grade of squamous cell carcinoma or adenocarcinoma

# entry[].resource.item[].item[].item[].code[].display
Other squamous cell carcinoma or adenocarcinoma

# entry[].resource.item[].item[].item[].text
Other squamous cell carcinoma or adenocarcinoma

# entry[].resource.item[].item[].code[].display
Specified location of microscopic extent in invasion

# entry[].resource.item[].item[].text
Specified location of microscopic extent in invasion

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
Tumor invades superficial muscularis propria (inner half)

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
Tumor invades deep muscularis propria (outer half)

# entry[].resource.item[].item[].item[].item[].code[].display
Other tumor involves adjacent structures

# entry[].resource.item[].item[].item[].item[].text
Other tumor involves adjacent structures

# entry[].resource.item[].item[].item[].text
Confirmation technique of involved margin in invasive carcinoma

# entry[].resource.item[].item[].item[].item[].text
Specified direct vision technique for involved margin in invasive carcinoma

# entry[].resource.item[].item[].item[].item[].text
Specified urethral side of involved margin in invasive carcinoma

# entry[].resource.item[].item[].item[].item[].code[].display
Other involved margin of invasive carcinoma

# entry[].resource.item[].item[].item[].item[].text
Other involved margin of invasive carcinoma

# entry[].resource.item[].item[].code[].display
Margin status of noninvasive premalignant neoplasm

# entry[].resource.item[].item[].text
Margin status of carcinoma in situ/non-invasive high-grade urothelial carcinoma

# entry[].resource.item[].item[].item[].text
Confirmation technique of involved margin in noninvasive premalignant neoplasm

# entry[].resource.item[].item[].item[].item[].text
Specified direct vision technique for involved margin in noninvasive premalignant neoplasm

# entry[].resource.item[].item[].item[].code[].display
Involved margin of noninvasive premalignant neoplasm

# entry[].resource.item[].item[].item[].text
Involved margin of noninvasive premalignant neoplasm

# entry[].resource.item[].item[].item[].item[].text
Specified urethral side of involved margin in noninvasive premalignant neoplasm

# entry[].resource.item[].item[].item[].item[].code[].display
Other involved margin of noninvasive premalignant neoplasm

# entry[].resource.item[].item[].item[].item[].text
Other involved margin of noninvasive premalignant neoplasm

# entry[].resource.item[].item[].text
Number of positive regional lymph nodes.

# entry[].resource.item[].item[].code[].display
Anatomical location of histologically confirmed distant metastases

# entry[].resource.item[].item[].text
Anatomical location of histologically confirmed distant metastases

# entry[].resource.contained[].compose.include[].concept[].display
Suspected deep tissue injury, depth unknown, so stated

# entry[].resource.contained[].expansion.contains[].display
Suspected deep tissue injury, depth unknown, so stated

# entry[].resource.extension[].extension[].valueString
The patient that is to be used to pre-populate the form

# entry[].resource.extension[].extension[].valueString
The practitioner user that is to be used to pre-populate the form

# entry[].resource.extension[].extension[].valueString
The encounter that is to be used to pre-populate the form

# entry[].resource.item[].item[].item[].extension[].valueExpression.expression
(%patient.name.where(use='official').select((family | (given | prefix).join(' ')).join(', ') | text) | %patient.name.where(use!='official').select((family | (given | prefix).join(' ')).join(', ') | text)).first()

# entry[].resource.item[].item[].item[].text
Absent from service for the entire quarter

# entry[].resource.item[].item[].item[].text
Withheld consent for pressure injury assessment for the entire quarter

# entry[].resource.item[].item[].item[].text
Pressure Injuries Classification List (active)

# entry[].resource.item[].item[].item[].item[].text
Acquired outside of service during quarter?

# entry[].resource.item[].item[].item[]._text.extension[].valueString
Mark section as complete

# entry[].resource.item[].item[].item[].text
Physical restraints present during assessment period

# entry[].resource.item[].item[].item[].item[].answerOption[].valueCoding.display
a. Full bed rails on all open sides of bed

# entry[].resource.item[].item[].item[].item[].answerOption[].valueCoding.display
4. Used nights and days, but not constant

# entry[].resource.item[].item[].item[].item[].answerOption[].valueCoding.display
5. Constant use for full 24 hours (may include periodic releases)

# entry[].resource.item[].item[].item[].text
Restrained through use of secure area during assessment period

# entry[].resource.item[].item[].item[]._text.extension[].valueString
Mark section as complete

# entry[].resource.item[].item[].item[]._text.extension[].valueString
Mark section as complete

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
0. Continent - Complete control; DOES NOT USE any type of catheter or other urinary collection device

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Control with any catheter or ostomy over last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
2. Infrequently incontinent - Not incontinent over last 3 days, but does have incontinent episodes

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Occasionally incontinent—Less than daily

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
4. Frequently incontinent—Daily, but some control present

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
8. Did not occur—No urine output from bladder in last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
0. Continent - Complete control; DOES NOT USE any type of ostomy device

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
1. Control with ostomy - Control with ostomy over last 3 days

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
2. Infrequently incontinent - Not incontinent over last 3 days, but does have incontinent episodes

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
3. Occasionally incontinent — Less than daily

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
4. Frequently incontinent — Daily, but some control present

# entry[].resource.item[].item[].item[].answerOption[].valueCoding.display
8. Did not occur — No bowel movement in last 3 days

# entry[].resource.item[].item[].item[].item[].answerOption[].valueString
1A: Persistent redness without clinical signs of infection

# entry[].resource.item[].item[].item[].item[].answerOption[].valueString
1B: Persistent redness with clinical signs of infection

# entry[].resource.item[].item[].item[].item[].answerOption[].valueString
2A: Skin loss without clinical signs of infection

# entry[].resource.item[].item[].item[].item[].answerOption[].valueString
2B: Skin loss with clinical signs of infection

# entry[].resource.item[].item[].item[]._text.extension[].valueString
Mark section as complete

# entry[].resource.item[].item[].item[].item[].item[].answerOption[].valueString
Incontinent (or needs to be given enemata)

# entry[].resource.item[].item[].item[].item[].item[].extension[].valueExpression.expression
iif (%ADLBowels = 'Incontinent (or needs to be given enemata)', 0, (iif (%ADLBowels = 'Occasional accident (once per week)', 1, (iif(%ADLBowels = 'Continent', 2, {})))))

# entry[].resource.item[].item[].item[].item[].item[].answerOption[].valueString
Incontinent, or catheterised and unable to manage

# entry[].resource.item[].item[].item[].item[].item[].answerOption[].valueString
Occasional accident (max once per 24 hours)

# entry[].resource.item[].item[].item[].item[].item[].extension[].valueExpression.expression
iif (%ADLBladder = 'Incontinent, or catheterised and unable to manage', 0, (iif (%ADLBladder = 'Occasional accident (max once per 24 hours)', 1, (iif(%ADLBladder = 'Continent (for over 7 days)', 2, {})))))

# entry[].resource.item[].item[].item[]._text.extension[].valueString
Mark section as complete

# entry[].resource.contained[].description
The gender of a person used for administrative purposes.

# entry[].resource.contained[].copyright
Copyright © 2011+ HL7. Licensed under Creative Commons "No Rights Reserved".

# entry[].resource.item[].item[].item[].text
Type 'female' or 'male' into the Gender controller string field below.